MANAGING A FELINE PANLEUKOPENIA OUTBREAK IN A SHELTER DR. AMANDA - - PDF document

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MANAGING A FELINE PANLEUKOPENIA OUTBREAK IN A SHELTER

• DR. AMANDA DYKSTRA

UNIVERSITY OF TENNESSEE, SHELTER MEDICINE ASSOCIATION OF SHELTER VETERINARIANS, BOARD OF DIRECTORS

Association of Shelter Veterinarians

The Association of Shelter Veterinarians seeks to advance and support the practice of shelter medicine in order to improve community animal health and well-being.

Join us! www.sheltervet.org

Membership open to veterinarians, veterinary students, and non- veterinary affiliates.

OUTLINE

• HISTORY AND BACKGROUND INFORMATION
• SHELTER “TOUR”
• DEVELOP DEFICIENCY AND PROBLEM LIST
• OUTBREAK RESPONSE
• LONG TERM GOALS
• QUESTIONS

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HISTORY

• MAGPIE COUNTY ANIMAL SHELTER
• MUNICIPAL, OPEN-ADMISSION FACILITY IN RURAL APPALACHIA
• PREVIOUS SHELTER CONSULT IN 2014
• FOLLOWED FOR 8 MONTHS POST-CONSULT
• 100% URTD RATE
• OVERCROWDING
• LACK OF CLEANING, INTAKE, AND PREVENTATIVE CARE PROTOCOLS
• LOW LRR’S
• LOW SURGICAL STERILIZATION RATES (BOTH SHELTER ANIMALS AND

COMMUNITY)

MOST RECENT (2013) DATA

• INTAKE=2200 (1200 CATS)
• ADOPTIONS=300 (25%)
• ON-SITE =150
• OFF-SITE=150
• TRANSFERRED=40 (3.3%)
• RTO=10 (0.8%)
• EUTHANASIA=838 (69.8%)
• UNASSISTED DEATH= 12 (1%)
• LOS = “ADOPTABLE” = 38 DAYS “UNADOPTABLE” = 8 DAYS

BASIC BUILDING DESIGN

• TWO DESIGNATED CAT HOUSING AREAS
• ADOPTION WITH 16 STAINLESS STEEL KENNELS (61CMX30XMX71CM)
• INTAKE WITH 14 SIMILAR KENNELS
• EXAM ROOM
• CONTAINED 6 KENNELS SMALLER THAN THOSE IN ADOPTION
• LAUNDRY ROOM
• LARGE (DOG) SCALE
• GROOMING TUB
• REFRIGERATOR
• BREAK AREA

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BACKGROUND INFORMATION

• LEGALLY REQUIRED HOLD TIME = 3 CALENDAR DAYS
• FOUR FULL TIME STAFF, TWO PART TIME ACO’S, THREE INMATES
• CONSULT REQUESTED SUMMER 2016 FOR “SUDDEN DEATH” IN CATS

OF ALL AGES

• REPORTS THAT UP TO 5 CATS WERE FOUND DECEASED DAILY
• STAFF REPORTED FEW TO NO CLINICAL SIGNS PRIOR TO DEATH

SHELTER TOUR SHELTER TOUR

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SHELTER TOUR SHELTER TOUR SHELTER TOUR

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SHELTER TOUR SHELTER TOUR SHELTER TOUR

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SHELTER TOUR SHELTER TOUR SHELTER TOUR

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SHELTER TOUR SHELTER TOUR SHELTER TOUR

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SHELTER TOUR SHELTER TOUR SHELTER TOUR

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SHELTER TOUR SHELTER TOUR WHAT WE LEARNED FROM THE TOUR AND HISTORY

• GENERAL LACK OF SANITATION
• LACK OF HUMANE ANIMAL CARE AND HOUSING
• STAFF IS NOT RECOGNIZING SIGNS OF ILLNESS
• FOOD NOT MEASURED, STORED OUTDOORS, AND CONTAINED

UNKNOWN WHITE POWDER.

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WHAT WE LEARNED FROM THE TOUR AND HISTORY

• CAT KENNELS LACKED APPROPRIATE RESOURCES
• LIMITED RECORD-KEEPING OR ANIMAL IDENTIFICATION
• A LARGE NUMBER OF FULL RABIES VIALS WERE FOUND IN SHARPS
• DOGS OVERCROWDED
• UNRELATED DOGS HOUSED TOGETHER
• PORTABLE KENNELS USED IN DOG HOUSING AREAS IN ADDITION TO

PERMANENT HOUSING

• EXAM ROOM USED AS DOG ISOLATION

WHAT WE LEARNED FROM THE TOUR AND HISTORY

• 70 CATS PRESENT
• 22 IN ADOPTION ROOM IN 16 SS KENNELS AND 3 PORTABLE KENNELS
• 18 IN INTAKE IN 14 SS KENNELS
• 12 IN HALLWAY IN PORTABLE KENNELS
• 11 IN LAUNDRY ROOM IN PORTABLE KENNELS
• 7 IN LOBBY IN 3 LARGE PORTABLE KENNELS

WHAT WE LEARNED FROM OBSERVING AND TALKING TO STAFF

• CATS ROAM FREE DURING CLEANING
• THOSE CLEANING AND PROVIDING DAILY CARE DID NOT RECOGNIZE

THAT PROTOCOLS EXISTED AND HAD RECEIVED NO TRAINING.

• NO DIAGNOSTICS WERE PERFORMED AT THE SHELTER

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WHAT WE LEARNED FROM OBSERVING AND TALKING TO STAFF

• THE STAFF BELIEVED MOST OF THE CATS IN THE SHELTER WERE

HEALTHY

• THE REFRIGERATOR DIDN’T WORK WELL.
• THE KENNEL MANAGER REPORTED ALL CATS RECEIVED FVRCP UPON

INTAKE BUT HAD NO RECORDS.

PARTIAL DEFICIENCY LIST

• MANY CATS WITH ILLNESS OR INFECTION THAT WERE APPARENTLY

NOT BEING TREATED

• ESSENTIALLY NO SANITATION/CLEANING PROTOCOLS
• OVERCROWDING
• NO MEDICAL RECORDS OR INTAKE DOCUMENTATION
• LACK OF BASIC ANIMAL CARE (FOOD, WATER, HEAT SOURCE)

PARTIAL DEFICIENCY LIST

• NUTRITIONAL CONCERNS
• VACCINATIONS? IF THEY WERE GIVEN, WERE THEY EFFECTIVE OR

GIVEN PROPERLY? WERE RE-VACCINATIONS GIVEN? WERE THEY STORED AT THE CORRECT TEMPERATURE?

• INHUMANE HOUSING
• MISUSE OF ANTIBIOTICS

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INITIAL PROBLEM LIST

• NASAL DISCHARGE
• OCULAR DISCHARGE
• SNEEZING
• BLEPHAROSPASM
• ULCERS ON TONGUE
• GINGIVITIS
• POOR BODY CONDITION
• DEHYDRATION
• DIARRHEA
• LETHARGY
• APPARENT ANOREXIA
• ECTOPARASITES
• GENERAL UNKEMPT APPEARANCE
• 2 LATERALLY RECUMBENT
• 1 UNRESPONSIVE TO STIMULI

OUTBREAK RESPONSE

EPIDEMIOLOGY REVIEW

• SPORADIC
• GOOD PREVENTION PROTOCOLS WITH HIGH COMMUNITY

VACCINATION RATES

• ENDEMIC
• GOOD PREVENTION PROTOCOLS WITH LOW COMMUNITY

VACCINATION RATES

• HYPERENDEMIC
• POOR PREVENTION PROTOCOLS WITH LOW COMMUNITY

VACCINATION RATES

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EPIDEMIOLOGY REVIEW

• OUTBREAK (EPIDEMIC)
• CLUSTER
• EPIDEMIC CURVE
• PLOT CASES OVER TIME
• ATTACK RATE
• #CASES/TOTAL POPULATION

IS THERE AN OUTBREAK?

EPIDEMIC

• FREQUENCY OR INCIDENCE OF

DISEASE IN EXCESS OF ITS EXPECTED

• FREQUENCY. IN SHELTERS WE LOOK

AT NUMBERS IN RELATION TO THE USUAL INCIDENCE FOR THAT SEASON OR MONTH.

• INCIDENCE GREATER THAN TWO

STANDARD DEVIATIONS ABOVE THE AVERAGE OBSERVED INCIDENCE.

ENDEMIC

• DISEASE IS REGULARLY AND

CONTINUOUSLY PRESENT. OFTEN USED AS BASELINE.

• WE NEED DATA TO KNOW IF

THERE IS AN OUTBREAK.

OUTBREAK MANAGEMENT

• HAVE A PLAN IN PLACE
• IMPLEMENT THAT PLAN IMMEDIATELY
• CLOSE/DEPOPULATION/CLEAN/RE-OPEN STILL PRACTICED
• OUTDATED
• SHOULD NOT BE CONSIDERED AN OPTION WITH MODERN SHELTER

MEDICINE

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IMMEDIATE RESPONSE

• STOP MOVEMENT TO PREVENT FURTHER SPREAD.
• DIVERT INTAKE IF POSSIBLE
• ASK “FINDERS” TO FOSTER TEMPORARILY
• OWNER RELINQUISHMENT WAIT LIST
• ASK A NEARBY SHELTER TO ASSIST
• CONSIDER A TEMPORARY SHELTER
• HALT ADOPTIONS
• COMMUNICATION! - DO NOT ALLOW RUMORS TO SPREAD UNCHECKED
• CLEAN BREAK IF CANNOT STOP STRAY INTAKE

GOALS OF STOPPING MOVEMENT

• ALLOWS FOR SWIFT OPERATIONAL CHANGES AND STAFF TRAINING
• IMPROVES CHANCES OF GOOD OUTCOME FOR CATS IN THE SHELTER
• ALLOWS FOR SPACE FOR QUARANTINE AND ISOLATION
• CONTAINS SPREAD OF ILLNESS AND PREVENTS SECONDARY

OUTBREAKS

INITIAL RISK ASSESSMENT

• ALLOWS FOR SEGREGATION OF ILL/EXPOSED ANIMALS
• INDIVIDUAL RISK
• IMMUNE STATUS
• VACCINATION STATUS
• AGE
• HEALTH STATUS
• LIKELIHOOD OF EXPOSURE
• PROXIMITY TO INFECTED ANIMALS
• CLEANLINESS OF ENVIRONMENT

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RISK ASSESSMENT

• GOALS
• ALLOW MOVEMENT THROUGH SHELTER
• DECREASE SUFFERING
• DECREASE EUTHANASIA

SAVE LIVES

INITIAL RISK ASSESSMENT

• FULL RISK ASSESSMENT ALLOWS FOR THE CREATION OF FOUR GROUPS
• INFECTED
• EXPOSED, NOT AT RISK
• EXPOSED, AT RISK
• NOT EXPOSED
• BUT WHAT ABOUT INITIAL RISK ASSESSMENT?
• HOW WOULD YOU GROUP THESE CATS?
• DO WE NEED DIFFERENTIALS FIRST?

DIFFERENTIAL DIAGNOSES NASOPHARYNGEAL DISEASE

• VIRAL
• FHV-1, FCV, ETC.
• BACTERIAL
• BB, MF

, SEZ, ETC.

• IRRITATION FROM POOR AIR QUALITY.

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DIFFERENTIAL DIAGNOSES OCULAR SIGNS

• VIRAL
• FHV-1, FCV, ETC.
• BACTERIAL
• MF

, CF, ETC.

• IRRITATION FROM POOR AIR QUALITY

DIFFERENTIAL DIAGNOSES ORAL LESIONS

• VIRAL
• FIV, FELV, FCV, FHV-1, ETC.
• CHEMICAL AGENTS
• DISINFECTANTS, PESTICIDES, ETC.
• TRAUMA
• BACTERIA
• PLAQUE

LET’S COMBINE THOSE INTO URTD

MORE LIKELY

• FHV-1
• FCV
• MF
• BB
• STREP CANIS
• SEZ

LESS LIKELY

• INFLUENZA
• CF
• FELINE REOVIRUS
• COWPOX VIRUS
• UNKNOWN EMERGING DISEASE
• IS THIS UNLIKELY IN THIS

SHELTER?

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LET’S COMBINE THOSE INTO URTD

• PASTEURELLA
• MICROCOCCUS
• MOXELLA
• ESCHERICHIA
• POSSIBLE SECONDARY BACTERIAL • DOES THE PURULENT DISCHARGE MEAN

WE HAVE A BACTERIAL COMPONENT?

DIFFERENTIAL DIAGNOSES POOR BODY CONDITION/WEIGHT LOSS

• LIMITED ACCESS TO PROPER NUTRITION
• POOR FEEDING, LOW QUALITY FOOD, BOWLS TOO LARGE OR TOO

HIGH FOR KITTENS TO REACH

• PROPER NUTRITION AVAILABLE BUT NOT INGESTED OR ABSORBED
• DYSPHAGIA, ANOREXIA, COMPETITION FOR FOOD, ORAL/DENTAL

DISEASE, VOMITING/DIARRHEA, ETC.

DIFFERENTIAL DIAGNOSES DEHYDRATION

• ANOREXIA
• LACK OF ACCESS TO WATER
• INABILITY OR UNWILLINGNESS TO DRINK DUE TO ORAL DISEASE OR

ANY OTHER CAUSE

• FLUID LOSS DUE TO VOMITING/DIARRHEA
• MULTITUDE OF OTHER CAUSES

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DIFFERENTIAL DIAGNOSES LETHARGY

• ANY CAUSE OF INFLAMMATION OR INFECTION
• ANEMIA
• NUTRITIONAL DEFICITS
• GI DISEASE

DIFFERENTIAL DIAGNOSES ANOREXIA

• ANYTHING THAT CAUSES NAUSEA
• GI AILMENTS
• DYSPHAGIA OR ORAL PAIN
• INABILITY TO SMELL FOOD
• FEVER
• TOXINS
• ANY CONDITION THAT LEADS TO DEPRESSION OR LETHARGY

DIFFERENTIAL DIAGNOSES DIARRHEA

• FPV
• CPV
• FELINE CORONAVIRUS
• CAMPYLOBACTER SPP.
• CLOSTRIDIUM PERFRINGENS
• SALMONELLA SPP.
• CRYPTOSPORIDIUM SPP.
• TRITRICHOMONAS FOETUS
• GIARDIA DUODENALIS
• HISTOPLASMA CAPSULATUM
• CYSTOISOSPORA SPP.
• TOXOCARA CATI
• TOXASCARIS LEONINE
• ANCYLOSTOMA TUBAEFORME
• FOOD INTOLERANCE
• DIETARY CHANGE
• INDISCRIMINANT FOOD INGESTION
• FOREIGN BODY INGESTION
• TOXIN INGESTION

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DIFFERENTIAL DIAGNOSES WHAT NEXT?

• LOOK FOR CLUES THAT HELP NARROW THE “MOST PRESSING” LIKELY

DIAGNOSIS

• AFFECTS ADULTS AS WELL AS KITTENS
• NO APPARENT DISINFECTION PROTOCOLS IN PLACE IN SHELTER
• HIGH NUMBER OF FATALITIES
• WORKERS DON’T APPEAR TO RECOGNIZE EVEN SEVERE CLINICAL SIGNS
• NO HISTORY OR RECORDS AVAILABLE TO PROVE VACCINATION STATUS
• CATS ALLOWED TO MINGLE DURING CLEANING
• DOGS APPEAR HEALTHY CONSIDERING THE LEVEL OF OVERCROWDING AND

APPARENT LACK OF SANITATION

IMMEDIATE DIAGNOSTICS WE CHOSE

• IN-HOUSE CPV FECAL ANTIGEN TEST
• FIRST 2 CATS TESTED WERE POSITIVE
• FECAL SAMPLES TO LOCAL VETERINARIAN FOR ROUTINE TESTING
• COCCIDIA IN VERY LARGE NUMBERS IN ALL SAMPLES
• ROUNDWORMS IN SOME SAMPLES
• TAPEWORM SEGMENTS SEEN IN SOME SAMPLES

DIAGNOSTICS WE CHOSE

• 7 CATS SENT TO UNIVERSITY LABORATORY
• FPV PCR
• FECAL SPECIMEN EXAMINATIONS
• ASKED FOR CULTURE IF PATHOLOGIST FELT DIAGNOSTIC TESTING DID NOT EXPLAIN CLINICAL SIGNS
• RESPIRATORY PANEL PCR
• FULL NECROPSY
• HISTOPATHOLOGY
• HOW DID WE CHOOSE THEM?
• COMMON CLINICAL SIGNS
• CATS THAT WOULD BE EUTHANIZED DUE TO HUMANE REASONS ANYWAY
• DIFFERENT AGES/SEXES/HOUSING UNITS
• DIFFERING INTAKE DATES?

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RISK ASSESSMENT OUTBREAK MANAGEMENT – RISK ASSESSMENT

• INFECTED
• MOVE TO ISOLATION IMMEDIATELY
• START TREATMENT
• ON- OR OFF- SITE
• EUTHANASIA
• SOMETIMES MOST HUMANE OPTION

INITIAL TRIAGE (AKA RISK ANALYSIS)

• WHAT DO WE DO WITH FPV-POSITIVE CATS IN MAGPIE COUNTY?
• BARRIERS TO CARE
• POOR RELATIONSHIP WITH LOCAL VETS AND RESCUE GROUPS
• LACK OF FUNDS AVAILABLE FOR TREATMENT
• LACK OF TRAINED STAFF
• LACK OF DIAGNOSTIC EQUIPMENT
• LACK OF MEDICAL EQUIPMENT FOR TREATMENT
• LACK OF ADEQUATE ISOLATION SPACE
• LACK OF ADOPTION OPTIONS POST-TREATMENT
• CAN WE PROVIDE THEM WITH HUMANE CARE?

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OUTBREAK MANAGEMENT – RISK ASSESSMENT

• NOT EXPOSED
• SAME RISK AS ANIMALS THAT ENTER IN NON-OUTBREAK PERIOD
• MAINTAIN PROCEDURES THAT KEPT THEM FROM BEING EXPOSED

OUTBREAK MANAGEMENT – RISK ASSESSMENT

• SEROLOGY HELPS DESIGNATE THOSE EXPOSED AND AT RISK VS

THOSE NOT AT RISK

• ONLY USEFUL FOR ASYMPTOMATIC ANIMALS
• IN-HOUSE TESTS AVAILABLE
• BIOGAL FELINE VACCICHECK TM

OUTBREAK MANAGEMENT – RISK CATEGORIES

High Risk

• Negative

titer

• Any age

Intermediate Risk

• Positive titer
• Juveniles

(<5m) Low Risk

• Positive titer
• Adults

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OUTBREAK MANAGEMENT – RISK ASSESSMENT

• HIGH RISK ANIMALS
• QUARANTINE
• 14 DAYS
• BATHE AT BEGINNING AND END OF QUARANTINE
• VERY IMPORTANT FOR JUVENILES

THIS IS NOT QUARANTINE! THIS IS NOT QUARANTINE!

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OUTBREAK MANAGEMENT – RISK ASSESSMENT

• INTERMEDIATE RISK
• BATHE
• MOVE IMMEDIATELY TO FOSTER, RESCUE, ADOPTION
• WAIVER
• CANNOT BE SURE IF TITER DUE TO VACCINATION OR MATERNAL

ANTIBODY

OUTBREAK MANAGEMENT – RISK ASSESSMENT

• LOW RISK
• PROCEED AS NORMAL

OUTBREAK MANAGEMENT – DECONTAMINATION

• CLEAN BREAK
• THOROUGHLY DISINFECT EACH AREA AS MOVE ANIMALS OUT
• SHOULD YOU LET THEM SIT EMPTY FOR 2 WEEKS?

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PROPER CLEANING/DISINFECTION

• 5% SODIUM HYPOCHLORITE (BLEACH) ½ CUP PER GALLON (1:32)
• INACTIVATED BY ORGANIC MATERIAL
• STORE IN LIGHT-PROOF CONTAINER
• STABLE FOR 1 MONTH AFTER DILUTION
• POTASSIUM PEROXYMONOSULFATE (TRIFECTANT)
• ACCELERATED HYDROGEN PEROXIDE (RESCUE)
• FOLLOW CONTACT TIMES!

INITIAL TRIAGE ONE POTENTIAL PLAN

• ONE OF THE LARGE CAT ROOMS - QUARANTINE ROOM
• OTHER LARGE CAT ROOM - ADOPTION ROOM
• EXAM ROOM – ISOLATION
• DIVIDED CATS BY CLINICAL SIGNS AND AGE RATHER THAN COHORT

OR WARD

• LACK OF SANITATION AND PROOF OF VACCINATION MEANT EVERYONE

HAD TO BE CONSIDERED EXPOSED/AT RISK UNTIL PROVEN OTHERWISE

PREPARE FOR MOVEMENT: HOW MANY CATS CAN WE CARE FOR IN THE SHELTER?

• 70 CATS-7 CHOSEN FOR NECROPSY=63 CATS
• “HUMANE” HOUSING UNITS AVAILABLE (PHYSICAL HOLDING CAPACITY)
• 16 IN FIRST ROOM (ADOPTION)
• 14 IN SECOND ROOM (INTAKE)
• 6 IN EXAM ROOM
• CAPACITY FOR DAILY CARE
• THREE INMATES SPENT 5 WORKING HOURS EACH AT SHELTER
• 1 HOUR EACH TO CLEAN LITTER BOXES AND FOOD BOWLS
• 15 MINUTES TO PROVIDE BASIC CARE FOR 1 CAT
• 4X60=240 X3=720 /15=48 CATS

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TRIAGE AND RISK ASSESSMENT ONE POTENTIAL PLAN

• DECONTAMINATE ALL SURFACES AND EQUIPMENT
• 1:64 DILUTION ACCELERATED H2O2 AS DETERGENT
• 1:32 DILUTION AS DISINFECTANT (CONTACT TIME 10 MINUTES)
• PUT PROPER PPE IN ISOLATION AND QUARANTINE ROOMS
• GOWNS
• GLOVES
• SHOE COVERS
• SEPARATE CLEANING AND ANIMAL CARE SUPPLIES

INITIAL TRIAGE ONE POTENTIAL PLAN

• PREVENTATIVE CARE ADMINISTERED DURING MOVEMENT
• MLV FVRCP SQ
• PYRANTEL PAMOATE 10 MG/KG PO
• PONAZURIL 50 MG/KG PO SID X 3 DAYS
• FIPRONIL TOPICALLY
• PRAZIQUANTEL PRN

INITIAL TRIAGE ONE POTENTIAL PLAN

• FIVE GROUPS
• BLACK TAGS
• GUARDED OR GRAVE PROGNOSIS WITHOUT IMMEDIATE OR EXTENSIVE

VETERINARY CARE

• VETERINARY CARE NOT AVAILABLE AND HOLDING THESE CATS WAS SEEN AS

INHUMANE

• RED TAGS
• CLINICAL SIGNS HIGHLY SUGGESTIVE OF FPV WITH OR WITHOUT URTD
• ALL TESTED WITH CPV FECAL ANTIGEN TEST +/- BLOOD SMEAR PRIOR TO

MOVEMENT

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INITIAL TRIAGE ONE POTENTIAL PLAN

• YELLOW TAGS
• MILD GI SIGNS THAT COULD BE DUE TO ENDOPARASITES AND A POOR DIET
• ALL TESTED FOR CPV WITH FECAL ANTIGEN TEST +/- BLOOD SMEAR
• GREEN TAGS
• SIGNS OF URTD WITH NO GI SIGNS
• ALL TESTED FOR ANTI-FPV ANTIBODY
• WHITE TAGS
• NO SIGNS OF URTD OR GI SIGNS
• ALL TESTED FOR ANTI-FPV ANTIBODY

INITIAL TRIAGE ONE POTENTIAL PLAN

• BLACK TAGS
• EUTHANIZED HUMANELY
• 11 JUVENILES, 2 ADULTS
• RED TAGS (3 ADULTS,6 JUVENILES)
• IF CPV ELISA POS-HUMANELY EUTHANIZED (2 ADULTS,4 JUVENILES)
• IF CPV ELISA NEG-BLOOD SMEAR EVALUATION BY LOCAL VET
• IF LEUKOPENIC-HUMANELY EUTHANIZED (1 ADULT,2 JUVENILES)

INITIAL TRIAGE ONE POTENTIAL PLAN

• YELLOW TAGS (3 ADULTS, 7 JUVENILES)
• IF CPV ELISA POS-HUMANELY EUTHANIZED (1 JUVENILE)
• IF CPV NEG-BLOOD SMEAR SENT TO LOCAL VET (NONE WERE LEUKOPENIC)
• IF NEITHER CPV POS NOR LEUKOPENIC
• TITER TESTED ALL 3 ADULTS (BUT STILL ISOLATED)
• ALL POSITIVE
• OUTCOME
• IMPROVED FOLLOWING PONAZURIL ADMINISTRATION
• ALL 3 LATER ADOPTED
• ISOLATED JUVENILES AS HIGH RISK (6 JUVENILES)
• USED EXAM ROOM AS ISOLATION WARD
• OUTCOME
• 5 LATER ADOPTED
• 1 DEVELOPED SEVERE URTD AND WAS PTS

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SEROLOGY RESULTS

• GREEN TAGS (17 ADULTS, 11 JUVENILES)
• TITER TESTED ALL
• POSITIVE TITERS 10 ADULT 6 JUVENILES
• ADULTS CONSIDERED LOW RISK
• JUVENILES CONSIDERED INTERMEDIATE RISK
• OUTCOME
• ADOPTED 10 ADULTS
• TRANSFER TO RESCUE 6 JUVENILES
• NEGATIVE TITERS 7 ADULT 5 JUVENILE
• QUARANTINED AS HIGH RISK
• OUTCOME
• ADOPTED 6 ADULTS 2 JUVENILES
• 1 ADULT EUTHANIZED AFTER TRYING TO BITE STAFF MEMBER
• 3 JUVENILES LITTER MATES EUTHANIZED WHEN TESTED POSITIVE ON CPV ELISA ON DAY 2 OF

QUARANTINE

SEROLOGY RESULTS

• WHITE TAGS (1 ADULTS, 2 JUVENILE)
• TITER TESTED ALL
• POSITIVE 1 JUVENILE 1 ADULT
• JUVENILE CONSIDERED INTERMEDIATE RISK
• SENT TO RESCUE
• LATER DEVELOPED FPV AND WAS TREATED WITH OUTPATIENT PROTOCOL AND SURVIVED
• ADULT CONSIDERED LOW RISK
• OUTCOME
• ADOPTED
• NEGATIVE 1 JUVENILE
• CONSIDERED HIGH RISK
• QUARANTINE
• OUTCOME
• ADOPTED

PREVENTING DISEASE DURING RESPONSE

• PROVIDE CATS WITH APPROPRIATE RESOURCES
• LITTER BOXES, FOOD/WATER BOWLS, HIDING BOXES
• LIMIT FOMITE SPREAD
• MEDICAL ROUNDS BID
• POPULATION ROUNDS OF ENTIRE FACILITY SID
• STRICT QUARANTINE AND ISOLATION PROTOCOLS
• PPE
• SEPARATION OF STAFF

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MEDICAL CARE

• SUPPORTIVE CARE FOR THOSE WITH MILD GI SIGNS OR URTD
• MONITOR BID FOR HYDRATION STATUS, APPETITE, DEMEANOR, STOOL

CONSISTENCY

• PROVIDE PALATABLE FOOD
• PROVIDE HIDING BOXES, SOFT BEDDING, QUIET AREA TO DECREASE

STRESS

• KEEP HUMAN TRAFFIC TO A MINIMUM

PATHOLOGISTS RESULTS

• ONE UNRESPONSIVE CAT HAD SPLENIC MALIGNANT FIBROUS

HISTIOCYTOMA WITH HEPATIC METASTASIS

• WHAT DOES THIS TELL US ABOUT THE POPULATION?

PATHOLOGISTS RESULTS

• 4 OF 7 FPV POSITIVE
• 5 OF 7 POSITIVE FOR CYSTOISOSPORA FELIS OR RIVOLTA (OR BOTH)
• 3 OF 7 POSITIVE FOR TOXOCARA CATI
• ENDOPARASITES + FPV=?

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PATHOLOGISTS RESULTS

• ALL TESTED FHV-1 NEGATIVE
• MOST LIKELY TO BE POSITIVE 6-12 DAYS AFTER ADMITTANCE
• FALSE NEGATIVES
• FEW CATS TESTED
• CATS WITH FHV-1 ALREADY DIED?
• 5 OF 7 FCV POSITIVE
• ALL CF AND BB NEGATIVE
• 4 OF 7 MF POSITIVE
• ENDOPARASITES+FPV+FCV=?

NOW WHAT? FACILITATE ADOPTIONS

• FREE ADOPTIONS
• LOCAL VETERINARY OR VET TECH SCHOOLS
• OFFER FREE VISIT VOUCHER FOR LOCAL VET
• PROVIDE WITH INFORMATION ABOUT POTENTIAL EXPOSURES
• SEND ALL ANIMALS WITH A MEDICAL RECORD

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OUTBREAK MANAGEMENT - COMMUNICATION

• AVOID “BAD PRESS”
• AVOID SECONDARY OUTBREAKS
• ADOPTERS, FOSTERS, EMPLOYEES, VOLUNTEERS, LOCAL

VETERINARIANS, LOCAL MEDIA

• ALL DESERVE ACCURATE AND TIMELY INFORMATION

COMMUNICATION MAGPIE COUNTY

• ATTEMPT TO CONTACT RECENT ADOPTERS
• RE-BUILD RELATIONSHIP WITH RESCUE PARTNERS AND OFF-SITE PET

ADOPTION CENTER

• COMMUNICATE WITH LOCAL VETERINARIANS
• MEDIA

DECONTAMINATION

• AS ANIMALS MOVE OUT DECONTAMINATE ENTIRE SHELTER
• MAINTAIN CLEAN BREAK

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PREVENT FUTURE OUTBREAKS: NEW PROTOCOLS IMPLEMENTED

• OPEN SELECTION
• FELINE HOUSING
• PREVENTATIVE CARE
• DISINFECTION/SANITATION
• SPOT CLEANING
• URTD MANAGEMENT
• INTAKE

OUTCOME

• JUVENILES
• PTS-22
• ADOPTED-8
• RESCUE TRANSFER- 7
• 1 SUCCESSFULLY TREATED
• ISOTONIC FLUID THERAPY, EARLY ENTERIC FEEDING, MAROPITANT, CEFOVECIN
• ADULTS
• PTS-6
• ADOPTED-20
• RETURN TO OPERATION- 10 DAYS

FOLLOW UP

• NO REPORTED CAT DEATHS POST-INVESTIGATION
• SHELTER STILL OVERCROWDED BUT IMPROVED

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LONG TERM GOALS

• FORMAL VOLUNTEER PROGRAM
• FOSTER PROGRAM
• STAFF AND INMATE TRAINING PROGRAM
• PROTOCOLS FOR MANAGEMENT OF COMMON MEDICAL AND

BEHAVIORAL CONDITIONS

• COMPASSION FATIGUE EDUCATION
• NUTRITIONAL PLAN

LONG TERM GOALS

• IMPROVED HOUSING FOR ALL SPECIES
• MICROSCOPE AND CENTRIFUGE IN FACILITY
• SCALE APPROPRIATE FOR CATS
• ADOPTION PROMOTION
• MEDICAL TRAINING FOR STAFF (PHLEBOTOMY, ETC.)
• CE FOR DIRECTOR AND STAFF

FINAL THOUGHT….

• DON’T FORGET THAT THE STAFF ARE HUMANS AND MAY HAVE BEEN

LED TO THESE DECISIONS BY COMPASSION FATIGUE AND BURNOUT.

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QUESTIONS?

Managing a Feline Panluekopenia in a Shelter 8/10/2017